MALAISE IN MEDICINE - WE DONT TEACH WHAT WE DO

I tested the hypothesis that the most frequently used textbooks of int ernal medicine are inadequate in their coverage of the evaluation and management of common complaints and management problems of primary car e. Fourteen common complaints (symptoms) and nine common management pr oblems (diseases) representing 20% to 40% of primary care patient visi ts were identified, and seven major textbooks of internal medicine wer e reviewed to assess the amount and extent of coverage of these topics . The average number of pages devoted to all 14 major problems was abo ut 30, or 1.5% of the total. About 40 (2%) of the pages addressed the nine management problems. The minimal amount of coverage devoted to th ese topics could be taken as evidence of the lack of respect, importan ce, and emphasis ascribed to them. The lack of instruction in these ar eas may enhance malaise in primary car medicine due to inadequate inst ruction in the needed data base and skills and the resultant patient d issatisfaction.